Papers by Birthe Loa Knizek
Frontiers in Psychology
BackgroundThe experiences of UK ethnic minority (UKEM) healthcare workers are crucial to ameliora... more BackgroundThe experiences of UK ethnic minority (UKEM) healthcare workers are crucial to ameliorating the disproportionate COVID-19 infection rate and outcomes in the UKEM community. We conducted a qualitative study on UKEM healthcare workers’ perspectives on COVID-19 vaccine hesitancy (CVH) in the UKEM community.MethodsParticipants were 15 UKEM healthcare workers (11 females; age range: 26–58 [43.3 ± 9.4] years). Data were collected using individual and joint interviews, and a focus group, and analyzed using thematic analysis.ResultsWe generated three themes: heterogeneity (two subthemes), mistrust (six subthemes), and mitigating (six subthemes). Therein, participants distinguished CVH in the UKEM community in educational attainment and ethnicity. They pointed to the role of mistrust in CVH in the UKEM community. They opined that the mistrust underlying CVH in the UKEM community is rooted in history and religion, conspiracy theories, the speedy development and novelty of the vaccin...
Our paper Why we need qualitative research in suicidology published in Suicide and Life-Threateni... more Our paper Why we need qualitative research in suicidology published in Suicide and Life-Threatening Behavior in 2010 has sparked some reactions from Lester (2010) and Rogers and Apel (2010). We are happy our paper created some debate. In the present paper we respond to the commentaries from Lester as well as Rogers and Apel and outline further why it currently is necessary to promote also "pure" qualitative research in suicidology. We hope this long overdue debate will continue.
Tidsskrift for Den norske legeforening
Ressurssenter om vold, traumatisk stress og selvmordsforebygging, region Midt-Norge (RVTS Midt) S... more Ressurssenter om vold, traumatisk stress og selvmordsforebygging, region Midt-Norge (RVTS Midt) St. Olavs hospital Julia Hagen (f. 1975) er rådgiver ved RVTS Midt og ph.d.-kandidat ved Institutt for psykisk helse, Norges teknisk-naturvitenskapelige universitet. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. HEIDI HJELMELAND Institutt for psykisk helse Fakultet for medisin og helsevitenskap Norges teknisk-naturvitenskapelige universitet Heidi Hjelmeland (f. 1960) er professor. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. KRISTIN ESPELAND Institutt for psykisk helse Fakultet for medisin og helsevitenskap Norges teknisk-naturvitenskapelige universitet Kristin Espeland (f. 1982) er ph.d.-kandidat. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. BIRTHE LOA KNIZEK Institutt for psykisk helse Fakultet for medisin og helsevitenskap Norges teknisk-naturvitenskapelige universitet Birthe Loa Knizek (f. 1957) er spesialist i klinisk psykologi (barn og ungdom) og professor. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.
Tidsskrift for Den norske lægeforening, 2018
Heidi Hjelmeland (f. 1960) er professor ved Institutt for psykisk helse, Norges teknisknaturviten... more Heidi Hjelmeland (f. 1960) er professor ved Institutt for psykisk helse, Norges teknisknaturvitenskapelige universitet. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. JULIA HAGEN Julia Hagen (f. 1975) er postdoktor ved Institutt for psykisk helse, Norges teknisk-naturvitenskapelige universitet. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. KRISTIN ESPELAND Kristin Espeland (f. 1982) er ph.d.-kandidat ved Institutt for psykisk helse, Norges teknisknaturvitenskapelige universitet. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. TOVE UELAND NYGAARD Tove Ueland Nygaard (f. 1971) er master i psykisk helsearbeid og psykiatrisk sykepleier ved Tiller DPS, St. Olavs hospital. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. BIRTHE LOA KNIZEK Birthe Loa Knizek (f. 1957) er spesialist i klinisk psykologi (barn og unge) og professor ved Institutt for psykisk helse, Norges teknisk-naturvitenskapelige universitet. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. 10. Large MM, Ryan CJ. Suicide risk categorisation of psychiatric inpatients: what it might mean and why it is of no use. Australas Psychiatry 2014; 22: 390-2. [PubMed][CrossRef]
Tidsskrift for Den norske lægeforening, 2014
En av de mest etablerte «sannheter» om selvmord er at psykiske lidelser spiller en viktig rolle v... more En av de mest etablerte «sannheter» om selvmord er at psykiske lidelser spiller en viktig rolle ved minst 90 % av dem. I dette ligger også en antakelse om årsakssammenheng. Evidensbasen for denne «sannheten» er imidlertid tvilsom fordi den er fremkommet ved studier som ikke holder mål. Her diskuteres noen alvorlige implikasjoner av dette.
Death Studies, May 23, 2017
One of the most well-established truths in suicidology is that mental disorders play a significan... more One of the most well-established truths in suicidology is that mental disorders play a significant role in at least 90% of suicides, and a causal relationship between the two is often implied. In this article, the authors argue that the evidence base for this truth is weak and that there is much research questioning the 90% statistic. Based on numerous examples, they also argue that ideology, politics, power, and vested interests among influential professionals in the field obstruct argument-based discussion of this issue. The authors also discuss unfortunate consequences of the constant reiteration of the 90% statistic.
Qualitative Health Research, Dec 2, 2019
In their article “‘What can we learn from first-person narratives?’ The case of nonfatal suicidal... more In their article “‘What can we learn from first-person narratives?’ The case of nonfatal suicidal behavior,” Bantjes and Swartz (2019) purport to “critically examine the practice of analyzing first-person narratives of nonfatal suicidal behavior to make truth claims about the causes of suicide” (p. 1497). However, by means of misrepresentations of our work and erroneous examples, their article aims to discredit qualitative suicide researchers as well as voices of people with lived experience of suicidality. By referring to three of our publications (Hjelmeland, 2013; Hjelmeland & Knizek, 2010, 2017), Bantjes and Swartz (2019) repeatedly state that we make “truth claims” about the “objective causes of suicide” based on “first-person-narratives of nonfatal suicidal behaviour.” Their argument is, however, based on a complete distortion of our work. Suicide is by definition a conscious, intentional, and purposeful act which is the end result of a complex process that is unique for each individual (Shneidman, 1985). An intentional act has meaning and is always situated in a sociocultural context (Bruner, 1990). Human beings do not act according to the rules of causal determinism and they are not disconnected from their context. Hence, we have argued that the concept of causality is highly problematic with relation to (suicidal) behaviour, that researchers rather should focus on contextual meanings of suicidality, and that for this, we need qualitative research. Such research allows us to consider more of individuals’ life history and context in the analysis than what is possible in the quantitative research that, for decades, has dominated the suicide research field (Hjelmeland, 2016). Thus, in qualitative research, we can learn more about the complexity involved in suicidal behavior. Meaning is not the same as objective cause. Because of all the problems connected to causal explanations of such a complex, contextual, and relational phenomenon as suicide, we have also argued that it might be fruitful to rather focus on teleological and/or intentional explanations and thus to understand suicidal behavior as communicative acts interpreted within the framework of communication theory (Hjelmeland & Knizek, 2010; Knizek & Hjelmeland, 2007). To “substantiate” their argument that we and other qualitative suicide researchers have made “truth claims based on first-person narratives of nonfatal suicidal behavior” (Bantjes & Swartz, 2019, p. 1499, italics added), Bantjes and Swartz (2019) list four excerpts from published articles. Three of their four examples are, however, not from qualitative studies of first-person narratives of nonfatal suicidal behavior, but from studies of third-person perspectives on fatal suicidal behavior, that is, from psychological autopsy studies where people bereaved by suicide were interviewed about the suicide of someone close to them. Their first example is not even from a qualitative study but from a traditional quantitative case–control psychological autopsy study (Zhang et al., 2004), and hence is not a narrative. Furthermore, their two chosen excerpts from our research are third-person narratives (Kizza et al., 2012a, 2012b). Based on interpretations of the narratives of several bereaved persons around each of a number of suicides, we state, in the excerpts used by Bantjes and Swartz (2019), that something “contributed to” or was “associated with” the suicides, as seen by the people bereaved by suicide (Kizza et al., 2012a, 2012b). Bantjes and Swartz (2019) then explicitly assert that we, by saying “associated with” and “contributed to” “make clear linear deterministic and causal claims about links between suicidal behavior and sociocultural phenomena on the basis of their analysis of first-person narratives” (p. 1499, italics added), and that we thus infer “objective causality” (p. 1499). This is a blatant inaccuracy. It is also common knowledge that association is not cause, which we even state explicitly in one of the publications they are referring to (Hjelmeland & Knizek, 2017). Bantjes and Swartz (2019) also claim that we have referred to people with lived experience of nonfatal suicidal behavior as the “real experts” on “the causes of suicidal behavior” (p. 1503). Here, they have cherry picked the phrase “real experts” from our work and presented it in decontextualized form. Our point is that people with lived experience are the real experts of their own lived experience; on the meaning(s) a suicidal act has for them 890310QHRXXX10.1177/1049732319890310Qualitative Health ResearchHjelmeland and Knizek letter2019
Routledge eBooks, Nov 23, 2021
Tidsskrift for Den norske lægeforening, 2010
Foundation of Ethics-Based Practices, 2021
Ethical Human Psychology and Psychiatry, 2018
Based on a 10-year systematic review of suicide prevention strategies, “29 suicide prevention exp... more Based on a 10-year systematic review of suicide prevention strategies, “29 suicide prevention experts from 17 European countries” recommend 4 allegedly evidence-based strategies to be included in national suicide prevention programs. One of the recommended strategies is pharmacological treatment of depression. This recommendation is problematic for several reasons. First, it is based on a biased selection and interpretation of available evidence. Second, the authors have failed to take into consideration the widespread corruption in the research on antidepressants. Third, the many and serious side effects of antidepressants are not considered. Thus, the recommendation may have deleterious consequences for countless numbers of people, and, in fact, contribute to an increase in the suicide rate rather than a decrease.
The psychosocial circumstances surrounding men’s suicide in postconflict Central Northern Uganda ... more The psychosocial circumstances surrounding men’s suicide in postconflict Central Northern Uganda were investigated using qualitative psychological autopsy interviews. Records of 17 men who died by suicide were identified through police and local leaders in Internally Displaced Peoples ’ camps of Amuru and Gulu Districts. Two to five signifi-cant others were interviewed around each case. Data were analyzed by interpretative phenomenological analysis (IPA). Lost dignity and social value, lack of hope for the family’s future, overwhelming family responsibility, and mental illness were circum-stances found to have preceded the suicides. The protracted war in the Northern region of Uganda left men in rural communities feeling disempowered and disenfran-chised. This may have contributed to suicidal behavior in some of them. Suicide pre-vention in this area needs to be multidisciplinary with an emphasis on helping both men and women understand and deal with the many social changes that hav...
Frontiers in Psychology, Aug 3, 2022
Background: The experiences of UK ethnic minority (UKEM) healthcare workers are crucial to amelio... more Background: The experiences of UK ethnic minority (UKEM) healthcare workers are crucial to ameliorating the disproportionate COVID-19 infection rate and outcomes in the UKEM community. We conducted a qualitative study on UKEM healthcare workers' perspectives on COVID-19 vaccine hesitancy (CVH) in the UKEM community. Methods: Participants were 15 UKEM healthcare workers (11 females; age range: 26-58 [43.3 ± 9.4] years). Data were collected using individual and joint interviews, and a focus group, and analyzed using thematic analysis. Results: We generated three themes: heterogeneity (two subthemes), mistrust (six subthemes), and mitigating (six subthemes). Therein, participants distinguished CVH in the UKEM community in educational attainment and ethnicity. They pointed to the role of mistrust in CVH in the UKEM community. They opined that the mistrust underlying CVH in the UKEM community is rooted in history and religion, conspiracy theories, the speedy development and novelty of the vaccines, post-vaccination complications/side effects, false positive test results, and social media and social support/influence. Participants recommended that interventions targeted at mitigating CVH in the UKEM community need to, in a non-judgmental way, tackle dis/misinformation and provide education, and incorporate UKEM healthcare worker endorsement. They also suggested such interventions be community-oriented, enhance the convenience of vaccination centers and the possibility of vaccine choice, and appreciate that overcoming CVH and accepting vaccination is a gradual process involving personal assessment of risks and benefits. Conclusion: CVH in the UKEM community is a multifaceted phenomenon requiring multicomponent interventions.
The meanings of suicidal behaviour to psychology students in Ghana: A qualitative approach
Psychiatria Danubina, 2006
Attitudes towards suicide and suicide prevention are important both in terms of implementation, q... more Attitudes towards suicide and suicide prevention are important both in terms of implementation, quality and results of intervention efforts. The purpose of this study was thus to assess and compare attitudes towards suicide and suicide prevention in groups of future gate keepers (medical, psychological and nursing students), staff at psychiatric clinics (psychiatrists, psychologists and psychiatric nurses) and authorities allocating money (politicians). A survey was conducted in various groups in Norway as part of a European multicentre study. The questionnaire mainly consisted of statements scored on a five-point Likert scale; from strongly agree to strongly disagree. A factor analysis was performed resulting in an eleven-factor model. Factor scores were compared between the groups. All groups scored on the negative side, and the politicians even less often than the other groups agreed that suicide is a right. Politicians also more often found suicide to be incomprehensible compare...
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Papers by Birthe Loa Knizek